Prevalence of Osteoporosis in COPD Prompts Need for Screening

Significant risk factors for osteoporosis among patients with COPD included low body mass index and the presence of sarcopenia.

Osteoporosis is prevalent in patients with chronic obstructive pulmonary disease (COPD) and this prevalence is similar across COPD populations in many countries, according to a study published in CHEST.

Researchers of this systematic review searched PubMed, CINAHL, EMBASE, and MEDLINE using the keywords “COPD,” “osteoporosis,” “prevalence,” and “risk factor.” Two reviewers independently screened the data for eligibility, data extraction, and quality assessment of the articles. Osteoporosis prevalence and risk factors were determined using meta-analyses, and meta-regression analysis was performed to explore sources of heterogeneity.

The combined analyses indicated a pooled global osteoporosis prevalence of 38% (95% CI, 34%-43%), and 15% in the control groups. Significant heterogeneity was seen in the included studies (I2=93%, P <.01), and meta-regression analyses showed that this heterogeneity was significantly associated with the recruitment source of patients with COPD (P <.001), COPD severity presented as forced expiratory volume in 1 second percent predicted (P =.01), the percentage of participants who were men (P =.03), and study sample size (P =.03).

Prevalence did not significantly differ among the 5 geographical regions: Americas, Eastern Mediterranean, Europe, South-East Asia, and Western Pacific. The adjusted pooled odds ratio (OR) of patients with COPD having osteoporosis was 2.83 (95% CI, 2.00-4.03). Significant risk factors for osteoporosis among patients with COPD included body mass index <18.5 kg/m2 (OR, 4.26; 95% CI, 1.07-16.99; P <.05) and the presence of sarcopenia (OR, 3.65; 95% CI, 1.45-9.16; P <.01).

Related Articles

The investigators concluded, ” Individuals with COPD at high risk for osteoporosis should be identified early through screening and strategies aimed at improving or controlling risk factors for osteoporosis should be implemented in the early stages of lung disease.”


Chen Y-W, Ramsook AH, Coxson HO, Bon J, Reid WD. Prevalence and risk factors for osteoporosis in individuals with chronic obstructive pulmonary disease: a systematic review and meta-analysis [published online July 25, 2019]. CHEST. doi:10.1016/j.chest.2019.06.036